ABSTRACT
Resumen La evaluación es un proceso sistemático que resulta en un juicio de valor para tomar decisiones. Los instrumentos empleados para obtener datos sobre el desempeño de los estudiantes requieren de un proceso sistemático y objetivo para su implementación. El mini-CEX es un instrumento de observación directa que ha sido empleado para la evaluación de la competencia clínica en los estudiantes de pre y posgrado desde su invención en 1955. Cuenta con diferentes evidencias de validez para su uso en distintos contextos educativos y clínicos. Permite realizar evaluaciones rápidas, acompañadas de realimentación y que proporcionan información relevante del desarrollo de la competencia clínica. El objetivo de este escrito es exponer la experiencia de la implementación del mini-CEX en el pregrado médico para la evaluación formativa de los estudiantes utilizando la simulación con pacientes estandarizados. Para lograr este objetivo se empleó la siguiente secuencia: búsqueda, planeación, integración y aplicación. Posterior a estos pasos se dan una serie de recomendaciones para la implementación del mini-CEX. Se concluye que la evaluación de la competencia clínica es importante para la mejora continua y permanente de los estudiantes de pre y posgrado. Es necesario sistematizar la evaluación ajustada siempre a objetivos y necesidades específicas de la evaluación.
Abstract Evaluation is a systematic process that results in a judgment to make decisions. The instruments used to obtain data on student performance require a systematic and objective process for their implementation. The mini-CEX is a direct observation tool that has been used for the evaluation of clinical competence in undergraduate and postgraduate students since its invention in 1955. It has different validity evidence for use in different educational and clinical contexts. It allows rapid evaluations, accompanied by feedback and providing relevant information on the development of clinical competence. The objective of this paper is to expose the experience of the implementation of the mini-CEX in the medical undergraduate for the formative evaluation of students using simulation with standardized patients. To achieve this goal, the following sequence was used: search, planning, integration, and application. After these steps we make some recommendations for the implementation of the mini-CEX. Its is concluded that the evaluation of clinical competence is important for the continuous and permanent improvement of undergraduate and graduate students. It is necessary to systematize the evaluation always adjusted to objectives and specific needs of the evaluation.
ABSTRACT
En el contexto de la pandemia de COVID 19 durante el año 2020 y hasta la fecha se diseñó un formato de evaluación para nuestros alumnos de pre y posgrado bajo el alero de los exámenes clínicos objetivos estructurados (ECOE) en un formato remoto. Se revisó la literatura al respecto y se diseñó un instrumento que diera cuenta en forma oportuna y estandarizada del desempeño de nuestros alumnos y residentes. Estas experiencias están siendo evaluadas en estudios con metodología mixta. Sin embargo, decidimos compartir esta experiencia, por su impacto en el desarrollo docente de las ciencias de la salud.
In the context of the COVID-19 pandemic during 2020 and to date, an evaluation format has been designed for our undergraduate and graduate students under the design of the objective structured clinical examinations (OSCE) in a remote format. The literature was reviewed, and an instrument was designed to account for the performance of our students and residents in a timely and standardized manner. These experiences are being evaluated in studies with mixed methodology. However, we wanted to convey this experience due to its impact on the educational development of health sciences.
ABSTRACT
Resumen A nivel internacional, se han elaborado modelos e instrumentos de evaluación de competencias genéricas y específicas; sin embargo, en Argentina los desarrollos han sido menores. Un relevamiento de psicoterapeutas locales concluye que al menos siete competencias clínicas básicas y cinco indicadores asociados a su desarrollo serían esenciales para desempeñarse como terapeutas (Crocamo, 2019). El objetivo de este trabajo fue construir un instrumento para su evaluación, denominado Escala de Competencias Clínicas Básicas para Psicoterapeutas (ECCBP). Para ello, se utilizó un diseño no experimental, transversal de tipo exploratorio en cuatro fases: (1) elaboración del sistema de evaluación; (2) redacción de ítems; (3) revisión de la versión preliminar; y (4) desarrollo del instrumento definitivo. Se aplicó el instrumento a 534 psicoterapeutas argentinos con título de grado de psicólogo. La versión definitiva quedó conformada por 122 ítems y para completarlo se requirieren aproximadamente 45 minutos. La elaboración de un instrumento local favorece el estudio sistemático del área y permite valorar de manera confiable la efectividad de los programas de entrenamiento.
Abstract At the international level, models and instruments for the evaluation of generic and specific competences have been developed; however, in Argentina the developments have been fewer. A survey of local psychotherapists concludes that at least seven basic clinical competencies would be essential to perform as therapists: diagnostic process and design, interventions and techniques, therapeutic bond, professional role, contextual variables and diversity, interview management and evaluation and completion of the process. Furthermore, five activities and experiences would be linked to their training, called associated indicators: basic training and updating, personal development and work on oneself, belonging to institutions and network of professionals, supervision, and personal and professional experience (Crocamo, 2019). Therefore, the objective of this work was to construct an instrument for its evaluation called Basic Clinical Competences Scale for Psychotherapists (BCCSP). To do this, a non-experimental, cross-sectional exploratory design was used in four phases: (1) development of the evaluation system; (2) writing of items; (3) review of the preliminary version; and (4) development of the final instrument. The instrument was applied to 534 Argentine psychotherapists with a degree in psychology. To attend to the particularity of each phase, three samples were used. The first one was composed of three psychotherapists summoned to participate in the selection of the different methodologies to evaluate each competence and indicator. For the second one, reviewers of the instrument made up of five therapists with different levels of professional experience summoned to assess the preliminary version of the instrument. And the third, to study the psychometric properties of the BCCSP, a snowball sample was used composed of 534 psychotherapists from 19 provinces of Argentina. As a result, different evaluation formats were incorporated in order to favor the effective evaluation of the variables, clinical vignettes, self-evaluation of perception of competences and questionnaire. A systematized procedure was carried out to review and refine the pilot version. The percentage of agreement between the reviewers of the instrument (Herrera Rojas, 1993) and the Aiken's V coefficient were calculated using software called Basic Visual Program for Aiken's V, developed by Merino Soto and Livia Segovia (2009). The final version was made up of 122 items and it takes approximately 45 minutes to complete it. The first part is composed of three vignettes which offer clinical descriptions with 15 questions for each situation. Finally, the responses are scored as correct / complete (2 points), correct / partial (1 point) or incorrect (0 points). Next, the self-assessment scale presents the following Cronbach's alpha coefficients Therapeutic link α = .833; Professional role α = .715; Contextual variables and diversity α = .853; Interview management α = .845; Evaluation and completion of the process α = .845 and Design, interventions and techniques II α = .797. Finally, the questionnaire was made up of 22 items: basic training and updating (5 items), personal and professional experience (5 items), personal development and work on oneself (4 items), supervision (4 items), membership in institutions and professional network (5 items). The answers collected will allow to obtain qualitative information on experiences or activities associated with the development of clinical competencies for psychotherapy. In the first place, it should be noted that the BCCSP is an instrument specially constructed for the local population and the study area that can be generalizable to other similar sociocultural contexts since the vast majority of evaluation models and studies have been developed in Anglo-Saxon countries. At the same time, due to the lack of local evaluation instruments, the BCCSP could become a valuable tool, both to be used in research activities and in training programs and educational monitoring.
ABSTRACT
Actualmente la tendencia en educación médica, es construir los proyectos pedagógicos basados en competencias. El aprendizaje en competencias posibilita la articulación teoría y práctica, y favorece la adquisición de aprendizajes significativos, lo que permitevalorar los procesos cognitivos de orden superior, tales como, razonamiento clínico, resolución de problemas, pensamiento crítico y habilidades de comunicación. Esta investigación se desarrolló en la Práctica Obligatoria Final de la Carrera de Medicina de la Universidad Nacional del Nordeste,situada en la provincia de Corrientes, Argentina.Tuvo como objetivo determinar lavalidez y confiabilidad del Examen Clínico Objetivo Estructurado (ECOE), como instrumento de evaluación, para constatar la adquisición de las competencias del egresado. Para ello se utilizó el Examen denominado (ECOE), Objective Structured Clinical Examination (OSCE por las siglas en inglés). Lainvestigación fuedescriptiva y de corte transversal. La población en estudio estuvo constituida por302estudiantes, que rindieron su examen final profesional, en el período diciembre 2005 a septiembre de 2008, desarrolladosen 14 turnos.Los resultadosmuestranla correlación entre el promedio de calificaciones de los 6 años de la carrera yel de competencia clínica (ECOE) en cada turno de examen y en cada área evaluada: Clínica, Cirugía, Pediatría y Obstetricia. Los resultados muestran que los exámenes, son de alta confiabilidad, con un rango entre 0,45 y 0,82 deAlfa de Cronbach. El promedio entre las correlaciones es de 0,65 lo que demuestra significancia estadística. Se demostró además, la validez en los catorce exámenes aplicados, con las pruebas de Anova, pruebas de Mann Whitney y Kruskal-Wallis lo cual indica que el número de estaciones fueron suficientes para lograr lo esperado de los estudiantes. Conclusión: el ECOE es una alternativa de evaluación de las competencias del futuro profesional médico que demostró confiabilidad y validez.Currently the trend in medical education is to build pedagogical projects based on competencies. Competency learning enables the articulation of theory and practice, and favors the acquisition of significant learning, which makes it possible to assess higher order cognitive processes, such as clinical reasoning, problem solving, critical thinking and communication skills. This research was developed in the Final Compulsory Practice of the Medicine Course of the National University of Norwest, located in the province of Corrientes, Argentina. Its objective was to determine the validity and reliability of theStructured Objective Clinical Exam (ECOE), as an evaluation instrument, to verify the acquisition of the graduate's competencies. For this, the so-called Test (ECOE), Objective Structured Clinical Examination (OSCE) was used. The investigation was descriptive and cross-sectional. The study population consisted of 302 students, who took their final professional exam, in the period December 2005 to September 2008, developed in 14 career and the clinical competence (ECOE) in each exam shift and in each area evaluated: Clinic, Surgery, Pediatrics and Obstetrics. The results show that the exams are highly reliable, with a range between 0.45 and 0.82 of Cronbach's Alpha. The average between the correlations is 0.65 which demonstrates statistical significance. In addition, the validity of the fourteen exams applied was demonstrated, with the Anova tests, Mann Whitney and Kruskal-Wallis tests, which indicates that the number of stations was sufficient to achieve what was expected of the students. Conclusion: ECOE is an alternative for evaluating the competencies of the future medical professional who demonstrated reliability and validity.Atualmente, a tendência na educação médica é construir projetos pedagógicos baseados em competências. O aprendizado por competência possibilita a articulação entre teoria e prática e favorece a aquisição de aprendizado significativo, o que possibilita avaliar processos cognitivos de ordem superior, como raciocínio clínico, resolução de problemas, pensamento crítico e habilidades de comunicação. Esta pesquisa foi desenvolvida na Prática Compulsória Final do Curso de Medicina da Universidade Nacional del Nordeste, localizada na província de Corrientes, Argentina. O seu objetivo foi determinar a validade e a confiabilidade do Exame Clínico Objetivo Estruturado (ECOE), como instrumento de avaliação, para verificar a aquisição das competências do graduado. Para isso, foi utilizado o chamado Teste (ECOE), Exame Clínico Objetivo Estruturado (OSCE). A investigação foi descritiva e transversal. A população do estudo foi composta por 302 alunos, que fizeram o exame profissional final, no período de dezembro de 2005a setembro de 2008, desenvolvido em 14 turnos.Os resultados mostram a correlação entre a média de notas da carreira de 6 anos e a competência clínica (ECOE) em cada turno de exame e em cada área avaliada: Clínica, Cirurgia, Pediatria e Obstetrícia. Os resultados mostram que os exames são altamente confiáveis, com intervalo entre 0,45 e 0,82 do Alpha de Cronbach. A média entre as correlações é de 0,65, o que demonstra significância estatística. Além disso, foi demonstrada a validade dos quatorze exames aplicados, com os testes Anova, Mann Whitney e Kruskal-Wallis, o que indica que o número de estações foi suficiente para atingir o que era esperado dos alunos. Conclusão: o ECOE é uma avaliação alternativa das competências do futuro profissional médico que demonstrou confiabilidade e validade
Subject(s)
Running/education , Medicine , Students, Medical , Reproducibility of Results , Competency-Based Education/methods , Education, Medical , Professional Training , Academic PerformanceABSTRACT
Introducción: el examen práctico estatal forma parte del proceso de fundamentar el título de licenciado en enfermería en muchas universidades, este debe evaluar la adquisición de las diferentes habilidades y actitudes en correspondencia con el diseño curricular en una forma homogénea. Objetivo: diseñar una guía de observación para el ejercicio de examen práctico estatal de la carrera de Licenciatura en enfermería. Métodos: se realizó una investigación educativa de desarrollo, entre enero y agosto del 2016 en la carrera de Licenciatura en Enfermería del Instituto Superior Politécnico "Sol Naciente" de Huambo, Angola. En la primera fase fue revisada la literatura, aplicado un instrumento de recolección de datos al currículo y aplicado la técnica de grupo focal, en la segunda fase fue construida la propuesta de guía de observación y en la tercera fase está fue valorada por especialistas. En la primera y tercera fase se utilizaron herramientas de estadística descriptiva. Resultados: la mayor parte de las asignaturas contribuyen a la formación asistencial seguida por la formación en ciencias básicas y naturales con 36,2 por ciento y 21,3 por ciento respectivamente. El instrumento elaborado verifica valores, actitudes y habilidades docentes-asistenciales-administrativas. Fue valorado el instrumento por los especialistas con la condición de excelente, para los aspectos de validez, confiabilidad e integralidad de esté con el 100 por ciento, 63,6 por ciento, 81,8 por ciento respectivamente. Conclusiones: el análisis de los resultados de la consulta a especialistas hace que se concluya que el instrumento elaborado es fácil de aplicar y permite evaluar con objetividad, validez y confiabilidad las competencias profesionales adquiridas(AU)
Introduction: The state practical exam is part of the process of founding a bachelor's degree in nursing in many universities, which must evaluate the acquisition of different skills and attitudes, in accordance with the curriculum design in a homogeneous way. Objective: Design an observation guide for the exercise of state practical examination of the Bachelor in Nursing. Methodical: Held an educational development research, between January and August of 2016, in degree in nursing of the Institute Superior Polytechnic Sol Nascente in Huambo, Angola. In the first phase, the literature was revised, a data collection instrument was applied to the curriculum and the focal group technique was applied. In the second phase the proposal for an observation guide was constructed and in the third phase it was evaluated by specialists. In the first and third phase, descriptive statistics tools were used. Results: Most of the subjects contribute to classroom training followed by training in basic and natural sciences with 36.2 percent and 21.3 percent respectively. The instrument checks drawn values, attitudes and teachers-care and administrative skills. It was the instrument valued by experts with excellent condition, for aspects of validity, reliability and integrity of this with 100 percent, 63.6 percent, 81.8 percent respectively. Conclusions: The analysis of the results of the consultation of specialists makes it possible to conclude that the instrument elaborated is easy to apply and allows to evaluate with objectivity, validity and reliability the acquired professional competences(AU)
Subject(s)
Humans , Examination Questions , Educational Measurement/methods , Licensure, NursingABSTRACT
INTRODUCCIÓN: la malaria continúa siendo uno de los más importantes problemas de la salud pública a nivel mundial y afecta severamente al continente africano. OBJETIVO: evaluar el nivel de conocimientos teóricos y prácticos en el diagnóstico de la malaria de un grupo de técnicos dedicados a esta actividad. MÉTODOS: entre los años 2010 y 2012, se realizó un estudio cuasi experimental de evaluación en la red de salud, en 14 laboratorios provinciales de las 18 provincias de la República Angola, donde se entrenaron 243 técnicos que realizan habitualmente el diagnóstico de la malaria. Se hicieron entrenamientos de 10 días (70 horas) cumplimentando un programa que incluyó clases prácticas y teóricas, y sus respectivas evaluaciones inicial y final. RESULTADOS: después de los entrenamientos en cada una de las 14 provincias evaluadas la frecuencia de los técnicos desaprobados en la evaluaciones teóricas y prácticas disminuyó significativamente, (p<0,01). CONCLUSIONES: este es el primer trabajo realizado en Angola donde se demuestra una mejoría cualitativa y cuantitativa tanto en los conocimientos teóricos y habilidades prácticas de los técnicos después de un entrenamiento y readiestramiento, y constituye el primer paso de un esfuerzo encaminado para mejorar el diagnóstico de la malaria en el país(AU)
INTRODUCTION: malaria continues to be one of the main public health problems worldwide, severely affecting the African continent. OBJECTIVE: evaluate the level of theoretical and practical competence in the diagnosis of malaria achieved by a group of technicians engaged in this activity. METHODS: an evaluative quasi-experimental study was conducted from 2010 to 2012 in 14 provincial laboratories from the 18 provinces of the Republic of Angola, where 243 technicians received training in the field of malaria diagnosis. Training extended for 10 days (70 hours) based on a syllabus which included theoretical and practical lessons as well as an initial and a final evaluation. RESULTS: a post-training evaluation conducted in 14 provinces showed a significant decrease in the number of technicians failing their theoretical and practical tests (p<0.01). CONCLUSIONS: this is the first evaluation carried out in Angola in which qualitative and quantitative improvement is observed both in the theoretical knowledge and the practical skills of technicians after receiving training or retraining. It is also a first step in an effort to improve the quality of malaria diagnosis in the country(AU)
Subject(s)
Humans , Mental Competency , Knowledge , Laboratories , Malaria/diagnosis , AngolaABSTRACT
La evaluación de competencias psicoeducativas resulta trascendental en el diseño de formación especializada para mejorar la intervención de quienes trabajan con adolescentes infractores. A través de un diseño cuasiexperimental pre y post, se evaluó el impacto de un proceso de formación en las competencias psicoeducativas de grupos de profesionales y técnicos. Utilizando el instrumento Test de Competencias Psicoeducativas, se observó que estas aumentan después de un proceso de formación especializado especialmente en técnicos, y preferentemente en la capacidad de planificación en ambos grupos. Se discuten los resultados en torno a las distinciones que se deben considerar en un programa de formación idóneo para cada grupo objetivo.
The assessment of psychoeducational skills is crucial in the design of specialized training to enhance the involvement of those working with offenders. Through a pre and post quasi-experimental design, we evaluated the impact of a process of training in psycho-educational skills of professionals and technicians. Using the Psychoeducational Competency Test, found that these skills improve after a specialized training process, especially in the technical group and preferably in the planning capacity in both groups. Results are discussed regarding the distinctions that should be considered in an appropriate training program for each target group.